Rokkjaer M S, Klug T E
Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark.
Clin Otolaryngol. 2018 Feb;43(1):1-6. doi: 10.1111/coa.12981. Epub 2017 Sep 25.
The prevalence of synchronous bilateral tonsil cancer remains unexplored. To date, only 38 cases have been described in the literature. With an aim to substantiate the Danish recommendation of performing bilateral tonsillectomy in patients with suspected or proven tonsil cancer and in patients with cervical carcinoma metastasis from an unknown primary tumour, this study was undertaken to determine the prevalence of synchronous bilateral tonsil cancer.
A retrospective review of all patients diagnosed with tonsil cancer in the period 2000-2015, Aarhus University Hospital, Denmark, was performed.
Seven of 211 (3.3%) consecutive patients with tonsil cancer, who had undergone bilateral tonsillectomy (n = 180) or unilateral tonsillectomy (clinically normal side) combined with contralateral tonsil biopsy (side with suspected cancer) (n = 31), had synchronous bilateral tonsil cancer. Furthermore, dysplasia was found in the contralateral tonsil in two patients with unilateral tonsil cancer. Four of 171 (2.3%) patients with suspected unilateral tonsillar cancer had additional contralateral tonsil cancer. Three of 34 (8.8%) patients without clinical signs of tonsillar malignancy on any side (32 patients with carcinoma of unknown primary) had synchronous bilateral tonsil cancer. In none of the patients were bilateral tonsil cancer suspected. Patients with unilateral vs synchronous bilateral tonsil cancer had similar clinical and tumour characteristics.
Knowledge on additional contralateral synchronous tonsil cancer is crucial for avoidance of early recurrence of oropharyngeal cancer in patients with tonsil cancer. Based on our findings, we recommend bilateral tonsillectomy in all patients with suspected or proven tonsil cancer and carcinoma of unknown primary.
同步双侧扁桃体癌的患病率仍未得到充分研究。迄今为止，文献中仅描述了38例病例。为证实丹麦关于对疑似或确诊扁桃体癌患者以及不明原发肿瘤的宫颈癌转移患者进行双侧扁桃体切除术的建议，本研究旨在确定同步双侧扁桃体癌的患病率。
对丹麦奥胡斯大学医院2000年至2015年期间所有诊断为扁桃体癌的患者进行回顾性研究。
211例连续接受双侧扁桃体切除术（n = 180）或单侧扁桃体切除术（临床正常侧）联合对侧扁桃体活检（疑似癌症侧）（n = 31）的扁桃体癌患者中，有7例（3.3%）患有同步双侧扁桃体癌。此外，在2例单侧扁桃体癌患者的对侧扁桃体中发现了发育异常。171例疑似单侧扁桃体癌患者中有4例（2.3%）还患有对侧扁桃体癌。34例双侧均无扁桃体恶性临床体征的患者（32例不明原发癌患者）中有3例（8.8%）患有同步双侧扁桃体癌。所有患者术前均未怀疑有双侧扁桃体癌。单侧与同步双侧扁桃体癌患者具有相似的临床和肿瘤特征。
了解额外的对侧同步扁桃体癌对于避免扁桃体癌患者口咽癌的早期复发至关重要。基于我们的研究结果，我们建议对所有疑似或确诊扁桃体癌以及不明原发癌的患者进行双侧扁桃体切除术。
